‘A hurley broke and flew into a guy’s mouth. He had four teeth broken’

Last week yours truly wrote about dentists in the NHL. Blood, stitches, exposed nerves, tooth fragments: Your basic Saturday night out. What about tooth loss in Irish sport, though?

“I was playing a match one time,” says John Browne.

“There was a clash ball and a hurley broke and flew into a guy’s mouth five yards away. He had four teeth broken and knocked out of position.”

Browne was at the other end of the field but trotted up to offer some professional advice:

I told him to pop them in milk and I’d see what I could do. But that’s a big difference from the old days. The time of ‘ah, the tooth’s gone, so what’ is well over.

“People will try to save their teeth and they know that their teeth can be saved thanks to the advances in dentistry.”

An All-Ireland-winning hurler with Cork in his playing days, Browne practises as a dentist in Belvedere Dental Care and the Citygate Specialist Dental Clinic: “I’m an endodontist and a lot of what I do is root treatments, so I deal with a lot of dental injuries in sport. I see quite a bit of it because I get referrals from dentists with those kinds of cases.”

Browne’s reference to a time when a missing tooth — or teeth — was the price of combat is notable. Go back a couple of decades and every post-game photo, be it Gaelic games, soccer, rugby, seemed to feature a few players without the full complement of pearly whites.

Much of what remained was less than pearly and less than white, come to that.

“One of the biggest things is the way dentistry has advanced,” says Browne.

“Before, if there was a problem, the tooth was extracted, but now the aim is to save the tooth if at all possible.

“Also, there was a time when people didn’t have that level of interest in their teeth. If a tooth was damaged it was just taken out. Gone. That’s different as well now.

“People are comfortable having cosmetic work done on their teeth, braces are very common and people of all ages wear them. If someone has a chipped tooth it can be rectified and usually is. How many people now do you see with chipped teeth?

“Or take a situation where it can look first like the teeth aren’t damaged but the nerve may be damaged, so you get people with a tooth that darkens over a period of time as the nerve dies.

“You’d have seen a lot more people with teeth like that in the past, but with the attention people pay to their teeth now it’s a lot rarer.”

That’s the general picture. What’s led to people keeping their teeth in sport?

“In sport alone the adoption of gum shields has made a huge difference in rugby, hockey, Gaelic football, and other sports. They prevent problems.

“The gum shield has a cushioning effect: Otherwise you have two hard surfaces hitting each other and something’s got to give. It’s acting as a shock absorber.

“I had a patient one time who got a sliotar into the side of the head and his jaws rattled with the impact; he had no gum shield because he had a helmet with a face mask. But with the impact he fractured his mandible and a couple of teeth because he had no gum shield to absorb the shock.

My own thought would be that hurlers should wear gum shields even with face masks, but I know the difficulties involved. I have two kids myself and I can’t get them to wear gum shields with their helmets.

“And part of the effect of the face mask is that before fellas might have pulled their faces back from hurleys flying around, which is natural, but now I think players are less fearful because of the face mask — which could in turn lead to more injuries.”

For all that, Browne stresses that he can’t declare definitively there are more fractured teeth in hurling: “It’s difficult for me to say that because I take referrals from other dentists of sportspeople with dental injuries.

“And because of that my numbers would be skewed in terms of the kinds of injuries I see, but my feeling would be that those dental injuries are still quite frequent despite the face masks.”

Are sportspeople nervous patients? “That’s quite common. Some of them are fellas you wouldn’t expect to be like that — sportspeople that you know well are tough competitors — yet they can be very nervous in the chair.

“It’s a phobia for some people, and a phobia is an irrational fear. Something you can’t explain. All you can do is make someone as comfortable as possible.

“Anaesthetics now are so good, for instance, that there’s no reason to feel pain, even though they may not work as quickly with some patients as others. But if the patient has gone to a dentist in the past and he or she felt pain, particularly as a child, then the phobia develops.

“If a parent is worried and anxious because he or she is nervous, then that’s going to transmit itself to the child, obviously.

“Every dentist’s strategy now is to make things comfortable for children in particular so they don’t have the kind of bad experience when they’re young that’ll turn them off.”

Sometimes an injury isn’t the reason the athlete ends up leaning back in the chair and saying ‘aah’.

“Diet is one issue,” says Browne.

“A lot of sportspeople have a very healthy diet, obviously, but the frequency with which they eat can be a problem.

“The amount of carbs they take because they’re told to snack regularly... every time you have a piece of fruit, for instance, that’s got sugar and acid in it which will attack the teeth. Unless they clean their teeth, flossing, chewing sugar-free gum after every snack, then they’ll end up with cavities and erosion.

“Power drinks are a problem as well. They’re supposed to sip them throughout the day and those drinks are full of sugar. Because of all of that sportspeople need to keep their teeth cleaner than other people do.”

Arsene Wenger famously had his players’ teeth checked out when he took over Arsenal. A good move, says Browne.

“Your gum health in particular is linked to cardiovascular disease, and you should keep your gums as clean as possible. A lot of cardiovascular disease is inflammatory, so the two (gum and cardiovascular) can be linked in the way.

“Plus, if a player needs wisdom teeth taken out, for instance, he could be right two days later or it could take two weeks to recover. If that happens in the middle of the season that’s the player ruled out for a while, obviously, so teams try to resolve those things in the offseason.”

The season itself throws up enough challenges. Browne points to the best example of the new attitude to dental damage: “Go back to Seamus Callanan against Limerick in 2015 — you could see pieces of teeth flying in the photograph taken just as he collided with a Limerick player.

“But the following day he was at a dentist in Cahir and got it sorted, which is the difference. That’s the awareness that it can be done — it has to be done straightaway, but it can be done.”